Document 0698
 DOCN  M94A0698
 TI    Mediastinal tuberculosis with oesophageal perforation.
 DT    9412
 AU    Dore G; St Vincent's Hospital, Darlinghurst, Sydney.
 SO    Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:32 (abstract no. FC2).
       Unique Identifier : AIDSLINE ASHM5/94348957
 AB    A 43 year old homosexual man, known seropositive for Human
       Immunodeficiency Virus (HIV) since 1984, with a CD4 Lymphocyte count of
       40 x 109/ml, but with no prior Acquired Immunodeficiency Syndrome (AIDS)
       defining illness, presented with a three-week history of fevers,
       non-productive cough, pleuritic chest pain and dysphagia. Physical
       examination revealed normal chest auscultation, no lymphadenopathy or
       hepatosplenomegaly. A chest x-ray showed some widening of the superior
       mediastinum, but the lung fields were clear. Endoscopic examination
       revealed a perforated oesophageal ulcer at 30 centimetres, and a
       gastrograffin swallow demonstrated a small leak into the mediastinum.
       Mycobacterium were seen on Auramine and Ziehl-Neelsen stains of the
       biopsies from the ulcer edge. A mediastinal biopsy grew Mycobacterium
       tuberculosis. The patient defervesced rapidly with standard
       anti-tuberculosis therapy and the perforation had healed at endoscopic
       follow-up one month later.
 DE    Adult  AIDS-Related Opportunistic Infections/*DIAGNOSIS/PATHOLOGY
       Biopsy  Case Report  Esophageal Diseases/*DIAGNOSIS/PATHOLOGY
       Esophageal Perforation/*DIAGNOSIS/PATHOLOGY  Esophagus/PATHOLOGY  Human
       Male  Mycobacterium tuberculosis/ISOLATION & PURIF  Tuberculosis,
       Gastrointestinal/*DIAGNOSIS/PATHOLOGY  MEETING ABSTRACT

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